Improve Type 2 Diabetes Management with Acceptance and Commitment Therapy

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Improve Type 2 Diabetes Management with Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

Acceptance and Commitment Therapy (ACT) – “Be more present to the “here-and-now.” This focus helps to decrease being caught up in what happened in the past. It also frees individuals from worrying too much about the future. Being present helps you to more fully connect to and enjoy the moment. Observe thoughts and feelings in such a way that they no longer keep you stuck in life. Learning to observe through openness and acceptance can help you find freedom from negative thoughts and feelings. Clarify your values and then take action. Finding what is most meaningful to you and choosing to act on these values are important parts of the therapy. This will be part of the process of building a rich and full life.” – VA Mental Health Services

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. Although this has been called adult-onset diabetes it is increasingly being diagnosed in children. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. A leading cause of this tissue resistance to insulin is overweight and obesity and a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control.

 

Recently, mindfulness practices have been shown to be helpful in managing diabetes. Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. It has been shown to be affective for a number of physical and psychological issues. The effectiveness of ACT to enhance management of Type II Diabetes is not known.

 

In today’s Research News article “A Randomized Controlled Trial of Acceptance and Commitment Therapy for Type 2 Diabetes Management: The Moderating Role of Coping Styles.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132195/

Shayeghian and colleagues recruited adult (40-60 years of age) patients with Type II Diabetes and randomly assigned them to either receive a one day diabetes health education training or health education plus 10 weeks, once a week two hour session, of group Acceptance and Commitment Therapy (ACT). The participants were measured prior to, after, and 3 months after the intervention for Glycated hemoglobin (HbA1C), diabetes self-care activities, acceptance of diabetes-related thoughts and feelings, and coping styles.

 

They found that ACT, in comparison to education only, resulted in significantly lower glycated hemoglobin, higher self-care activities and higher acceptance scores. This suggests that ACT promotes self-care and acceptance of their disease which translates into better plasma glucose management. Importantly, these benefits were still significant three months after treatment, suggesting that the effects are enduring. They also found that patients with effective coping styles had a greater impact of ACT on their self-care, suggesting that ACT works better for people who use effective strategies to cope with their disease.

 

These are exciting results, as Type II diabetes is so prevalent and effective self-care so important to the health of the patient. They suggest that ACT  improves the self-care that is so important for successful disease management. But the conclusions must be tempered with the fact that the control condition did not have an additional active intervention, e.g. exercise. So, the results could have been due to placebo effects, experimenter bias, attentional effects, etc. These results, though provide support for implementing a larger randomized controlled clinical trial with an active control condition or comparison to other active treatments.

 

So, improve Type 2 Diabetes management with Acceptance and Commitment Therapy.

 

“Results show that participants walked significantly further following the programme, and had lower levels of anxiety, depression and diabetes-related distress. Average blood glucose levels (HbA1c) were shown to have reduced by 0.6%. Qualitative interviews showed that participants found ACT Now! to be engaging, acceptable, attractive and helpful.” – NHS Grampian

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Shayeghian, Z., Hassanabadi, H., Aguilar-Vafaie, M. E., Amiri, P., & Besharat, M. A. (2016). A Randomized Controlled Trial of Acceptance and Commitment Therapy for Type 2 Diabetes Management: The Moderating Role of Coping Styles. PLoS ONE, 11(12), e0166599. http://doi.org/10.1371/journal.pone.0166599

 

Abstract

Background and Aim

Evidence of the efficacy of existing psychological interventions for self-management in diabetes is limited. The current study aimed at assessing the effects of group-based ACT on self-management of patients with T2DM, considering the moderating role of coping styles.

Methods

One hundred and six patients with type 2 diabetes were randomly assigned either to the education alone (n = 53) or to a combination of education and group-based acceptance and commitment therapy (n = 53) over a period of 10 sessions. In each group, 50 participants completed a 3 month follow-up assessment.

Results

After 3 months, compared to patients who received education alone, those in the group-based acceptance and commitment therapy condition were more likely to use effective coping strategies, reported better diabetes self-care, and optimum glycated hemoglobin (HbA1C) levels in the target range.

Conclusions

Consideration of the role of coping style for a more accurate evaluation of the effects of acceptance and commitment therapy may be a useful addition to services provided for patients with type 2 diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132195/

Improve Treatment Resistant Depression with Mindfulness

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Improve Treatment Resistant Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat and usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression.

 

Being depressed and not responding to treatment (Treatment Resistant Depression) or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can be applied when the typical treatments fail. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. In order to identify the best possible treatment, it is particularly important to investigate MBCT’s efficacy for Treatment Resistant Depression relative to other treatments that place equivalent demands upon the patients.

 

In today’s Research News article “A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Eisendrath and colleagues compared the relative efficacy of MBCT to a structurally equivalent active comparison condition, a Health-Enhancement Program. They recruited adults who were diagnosed with Major Depressive Disorder who were taking antidepressant medication. They were encouraged to continue their antidepressant medication while participating in the study. They were randomly assigned, stratified by gender, to receive 8-weeks of either standard Mindfulness Based Cognitive Therapy (MBCT) treatment or the Health-Enhancement Program. Both groups met once a week for 2 ¼ hours and were assigned 45 minutes of homework 6 days per week. The MBCT program included training in skills to identify cognitive distortions and to disengage from depression-focused ruminative thinking patterns, body scans, sitting meditations, three-minute breathing spaces, and mindful movement. The Health-Enhancement Program included aerobic exercise, functional movement, music therapy, and dietary education. The participants were evaluated for depression levels, and expectancies of treatment effects before and after treatment and mid-treatment (4-weeks).

 

They found that MBCT, in comparison to the Health-Enhancement Program produced a significantly greater reduction in depression (36.6% vs. 25.3%). In addition, MBCT treatment had a significantly greater proportion of patients respond to treatment. MBCT also produced higher, albeit not significantly different, rates of depression remission (22.4%). The two groups did not differ in their expectations that treatment would be successful, suggesting equivalent placebo effects. Hence, MBCT, was found to be superior to a structurally equivalent Health-Enhancement Program treatment in reducing depression in patients with Treatment Resistant Depression (TRD).

 

These are exciting results and strengthen the case that Mindfulness Based Cognitive Therapy (MBCT) is an effective treatment for the very difficult to treat Treatment Resistant Depression. MBCT uses mindfulness training and cognitive training to allow the patients to reprogram their thought patterns and how they interpret experiences, recognizing that their thoughts are only, just that, thoughts and not reflective of their selves. They learn to experience their emotions but adaptively react to them, seeing them as simply experiences that come and go. This helps them release rumination about past and future problems and focus on the present. This appears to go to the core of the psychological aspects of the disorder and greatly enhance the patient’s ability to cope with their depression.

 

So, improve treatment resistant depression with mindfulness.

 

“MBCT enables people to relate mindfully to the self and with others. The key, it seems, lies in the way MBCT enhances relationships: Less stress about relationships in turn helps prevent future episodes of depression.” – Emily Nauman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Eisendrath, S. J., Gillung, E., Delucchi, K. L., Segal, Z. V., Nelson, J. C., McInnes, L. A., … Feldman, M. D. (2016). A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression. Psychotherapy and Psychosomatics, 85(2), 99–110. http://doi.org/10.1159/000442260

 

Abstract

Background

Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.

Methods

This single site, randomized controlled trial compared 8-week courses of MBCT and the Health-Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD.

The primary outcome was change in depression severity, measured by percent reduction in total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.

Results

We enrolled 173 adults, mean length of current depressive episode was 6.8 years (sd = 8.9). At the end of 8-week treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction on the HAM-D17 (36.6% versus 25.3%; p=.01) and a significantly higher rate of treatment responders (30.3% versus 15.3%; p=.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4% versus 13.9%; p=.15). In these models, state anxiety, perceived stress, and the presence of personality disorder had adverse effects on outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756643/

Reduce Medical Student’s Stress Response with Yoga

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Reduce Medical Student’s Stress Response with Yoga

 

By John M. de Castro, Ph.D.

 

“By reducing perceived stress and anxiety, yoga appears to modulate stress response systems. This, in turn, decreases physiological arousal — for example, reducing the heart rate, lowering blood pressure, and easing respiration.” – Harvard Mental Health Letter

 

Medical School is challenging both intellectually and psychologically. Stress levels are high and burnout is common. It’s been estimated that 63% of medical students experience negative consequences from stress while symptoms of severe stress were present in 25% of students. The prevalence of stress is higher among females than among males. High stress levels lead to lower performance in medical school and higher levels of physical and mental health problems, especially anxiety and depression. Indeed 50% of medical students report burnout and 11% have considered suicide in the last year.

 

Obviously, there is a need to either lower stress levels in medical education or find methods to assist medical students in dealing with the stress. One promising possibility is mindfulness training. It has been shown to reduce both the psychological and physiological responses to stress. It has also been shown to reduce stress in students, to help with the negative consequences of stress, and to reduce burnout in medical professionals. So, it would seem reasonable to suspect that mindfulness would be helpful in assisting medical students cope with the stress of their training.

 

Yoga practice is a mindfulness technique that has been found to have extensive physical and psychological benefits and has the additional benefit of being also a physical exercise. This may be particularly beneficial for stressed medical students. In today’s Research News article “Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174168/

Prasad and colleagues recruited male and female medical students who did not practice yoga. The participants attended a one hour Hatha yoga class, twice a week, for six weeks. They were measured before and after training for perceived stress, happiness, peace, focus, endurance, positivity, personal satisfaction, self-confidence, patience, and fatigue.

 

They found that after the yoga practice there was a significant reduction in perceived stress and significant increases in peace, focus, and endurance. In addition, there were no adverse effects and the students were very positive about participation. Hence, they found that after yoga practice there was significant improvement in the medical students’ stress levels and psychological state.

 

This study is a pilot, proof of concept study, that did not include a control condition. So, conclusions need to be tempered. Without an active control condition a large number of confounding factors, including placebo effects, attention effects, experimenter bias, maturation effects, etc., are potential explanations for the significant improvements. The study, though is encouraging and provides evidence supporting conducting a large randomized controlled clinical trial of the effectiveness of yoga for the treatment of stress in medical students.

 

“The science is now in: practice in mindfulness meditation decreases stress and can help you avoid the negative outcomes of burnout and loss of empathy. Mindfulness practice can also help you study more efficiently and retain more information from class lectures. It can increase your quality of life and, in some people, it protects against depression. And of all of these effects are founded upon changes in basic brain structures and function. “ – Brown University School of Medicine

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Prasad, L., Varrey, A., & Sisti, G. (2016). Medical Students’ Stress Levels and Sense of Well Being after Six Weeks of Yoga and Meditation. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 9251849. http://doi.org/10.1155/2016/9251849

 

Abstract

Objective. To determine the effect of six weeks of yoga and meditation on medical students’ levels of perceived stress and sense of wellbeing prior to taking their exams. Methods. We conducted a prospective case-control study of first-through-third-year medical students at our academic institution, measuring levels of perceived stress and sense of wellbeing before and after a six-week yoga and meditation intervention. Questionnaires used for evaluation included the perceived stress scale (PSS) and self-assessment surveys (SAS). The postintervention surveys were completed on the day of the students’ written exams. Results. A total of thirteen women and fourteen men participated. Median age was 28 (24 yrs–32 yrs). 48.1% were Caucasian, 7.4% Black, 11.1% Hispanic, 11.1% Asian, and 22.2% other. Paired t-tests showed a statistically significant reduction in perceived stress (18.44 versus 14.52; p = 0.004) after the six-week yoga and meditation program. After the yoga intervention, self-assessment survey results showed a significant improvement in feelings of peace, focus, and endurance. Improvements in happiness, positivity, personal satisfaction, and self-confidence were also seen. An improvement in unsubstantiated parameters such as patience and fatigue was observed. Conclusion. Yoga and meditation may be effective in reducing stress levels and improving aspects of personal wellbeing in medical students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174168/

Improve Social and Physical Conditions in the Isolated Elderly with Tai Chi

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Improve Social and Physical Conditions in the Isolated Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age,” – Peter M. Wayne

 

We all want to live longer. We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline in every system in the body, the brain included. It cannot be avoided. Our mental abilities may also decline with age including impairments in memory, attention, and problem solving ability. These are called age related cognitive decline. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that the cognitive declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research. But, it has been found to be effective for an array of physical and psychological issues. It appears to strengthen the immune system, reduce inflammation and increase the number of cancer killing cells in the bloodstream.

 

Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. Tai Chi has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. The research, however, has studied socially active elderly. Unfortunately, many elderly individuals are socially isolated and do not often interact with others. These have been called the “hidden elderly.” It is not known if Tai Chi practice can be implemented and be effective with these socially isolated elderly individuals.

 

In today’s Research News article “Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221552/

Chan and colleagues recruited elderly (66 to 103, mean 77, years of age) who were socially isolated and did not engage in any social activities. They were randomly assigned to receive either treatment as usual (control group), including social worker visits and reminders of available services, or Tai Chi practice for 60 minutes, twice a week, for 3 months and they were encouraged to continue practice at home. They were measured before and after the 3-month practice period and again 3 months later for social support, loneliness, mental health, self-esteem, and quality of life.

 

They found that Tai Chi practice produced a significant reduction in loneliness, significant increase in total satisfaction with social support, and physical quality of life with large effect sizes that were maintained for 3 months after the end of the intervention. In addition, the participants stated that they enjoyed the Tai Chi practice and 82% planned to continue. Importantly, there were no adverse effects recorded from engaging in the practice. Hence Tai Chi practice was successfully implemented with the “hidden elderly” and was found to be a safe and effective practice to improve their social and physical conditions.

 

It should be noted that this was a small group pilot study which did not contain a control group. Hence, conclusions must be tempered. The study, however, does provide evidence that implementation of Tai Chi practice with the “hidden elderly” is feasible and provides a strong rationale to perform a large randomized controlled clinical trial with active control conditions. Regardless, it appears that Tai Chi practice may improve the social and physical conditions in the isolated elderly.

 

“The benefits of Tai Chi for seniors are incredible. If you are looking for a low-impact, relaxing form of exercise that only requires about 20 minutes a day and rewards your efforts, Tai Chi is for you.“ – Ryan Malone

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Chan, A. W., Yu, D. S., & Choi, K. (2017). Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial. Clinical Interventions in Aging, 12, 85–96. http://doi.org/10.2147/CIA.S124604

 

Abstract

Purpose

To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly.

Patients and methods

“Hidden elderly” is a term used to describe older adults who are socially isolated and refuse social participation. This pilot randomized controlled trial recruited 48 older adults aged 60 or above who did not engage in any social activity. They were randomized into tai chi qigong (n=24) and standard care control (n=24) groups. The former group underwent a three-month program of two 60-minute sessions each week, with the socially active volunteers paired up with them during practice. Standard care included regular home visits by social workers. Primary outcomes were assessed by means of the Lubben social network and De Jong Gieveld loneliness scales, and by a revised social support questionnaire. Secondary outcomes were covered by a mental health inventory and the Rosenberg self-esteem scale, and quality of life by using the 12-Item Short Form Health Survey. Data was collected at baseline, and at three and six months thereafter.

Results

The generalized estimating equations model revealed general improvement in outcomes among participants on the tai chi qigong program. In particular, participants reported a significantly greater improvement on the loneliness scale (B=−1.32, 95% confidence interval [CI] −2.54 to −0.11, P=0.033) and the satisfaction component of the social support questionnaire (B=3.43, 95% CI 0.10–6.76, P=0.044) than the control group.

Conclusion

The pilot study confirmed that tai chi qigong with elderly neighborhood volunteers is a safe and feasible social intervention for hidden elderly. Its potential benefits in improving social and psychological health suggest the need for a full-scale randomized controlled trial to reveal its empirical effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221552/

Improve ADHD in Children with Yoga

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Improve ADHD in Children with Yoga

 

By John M. de Castro, Ph.D.

 

“For individuals with the ADD/ADHD wiring, who have a tendency toward addiction and extreme behavior, building awareness is essential. Mindfulness and the ability to focus go hand-in-hand. I think of mindfulness as a muscle that can be strengthened through meditation/prayer, yoga, exercise, and self-discipline.” – Michael Ferguson

 

Attention Deficit Hyperactivity Disorder (ADHD) is currently epidemic in the US. Roughly 6.4 million American children have been diagnosed with ADHD and 6.4% of American children are being treated with medication. There has been a 42% increase in the diagnoses of ADHD in the last 8 years. It should be emphasized that this increase in diagnoses probably represents an increase in awareness and willingness to diagnose ADHD rather than an increase in cases of ADHD. “Many children who like to run and jump may be high-energy. But that doesn’t mean they are hyperactive. To count as ADHD, symptoms have to be on the extreme side and have to cause problems in the child’s life. Also, they have to have been doing this for at least 6 months.” – WebMD

 

What can be done about this huge problem that is affecting such a large proportion of American children and adults? The most common treatment is drugs, like methylphenidate, Ritalin, which helps reduce symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, including nervousness agitation, anxiety, irritability, sleep and appetite problems, head and stomach aches, nausea, dizziness, and heart palpitations. They can also be addictive and can readily be abused. If that’s not enough using drugs that alter the brain in children during the time of brain development is fraught with long-term risks. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.  Is there a better way?

 

There are indications that mindfulness training may be a more effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD, attention, impulse control, executive function, emotion control, and mood improvement. Yoga would appear to be particularly appropriate as it’s also an exercise and as such an outlet for some of the excess energy.

 

In today’s Research News article “Effects of an 8-week yoga program on sustained attention and discrimination function in children with attention deficit hyperactivity disorder.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237364/

Chou and Huang examine the ability of yoga training as a treatment for Attention Deficit Hyperactivity Disorder (ADHD). They recruited children between the ages of 8 to 12 who had been diagnosed with ADHD. They were assigned based upon their school district to either be in a no-treatment control group or receive yoga training for 40 minutes, twice a week, for 8 weeks. They were measured before and after training for concentrated targeted perception (visual pursuit task), for their “discrimination ability for reaction speed, attention deficits, and reactive stress tolerance in the presence of continuous but rapidly changing acoustic and optical stimuli” (Determination test), and physical fitness.

 

They found that the yoga practice resulted in a significant increase in accuracy and faster reaction time in the visual pursuit task, indicating improved concentration. They also found that the yoga practice produced a significant increase in accuracy and faster reaction time in the Determination test, indicating improves discrimination ability. Hence, it appears that yoga practice improves attention, both concentrated and selective in children with ADHD.

 

It needs to be remembered that the control group in the study did not receive any active treatment or exercise training. So, it cannot be determined if yoga practice was specifically responsible for the improvements or that any exercise or any intervention would have similar effects. It is possible that the increased attention, placebo effect, or experimenter bias effect might have been responsible. Future research should improve the control condition by including exercise and placebo control conditions. Regardless it is clear that the children treated with yoga practice markedly improved their attentional abilities.

 

So, improve ADHD in children with yoga.

 

“Those diagnosed with ADHD are often stressed, distracted and unable to focus. The benefits of yoga include stress relief, increased focus, self-awareness, meditation as well as confidence all things those with ADHD can benefit from without the use of medication.” – Carol Traulsen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Chou, C.-C., & Huang, C.-J. (2017). Effects of an 8-week yoga program on sustained attention and discrimination function in children with attention deficit hyperactivity disorder. PeerJ, 5, e2883. http://doi.org/10.7717/peerj.2883

 

Abstract

This study investigated whether a yoga exercise intervention influenced the sustained attention and discrimination function in children with ADHD. Forty-nine participants (mean age = 10.50 years) were assigned to either a yoga exercise or a control group. Participants were given the Visual Pursuit Test and Determination Test prior to and after an eight-week exercise intervention (twice per week, 40 min per session) or a control intervention. Significant improvements in accuracy rate and reaction time of the two tests were observed over time in the exercise group compared with the control group. These findings suggest that alternative therapies such as yoga exercises can be complementary to behavioral interventions for children with attention and inhibition problems. Schools and parents of children with ADHD should consider alternatives for maximizing the opportunities that children with ADHD can engage in structured yoga  exercises.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237364/

What’s Wrong with Meditation 1 – Expectations

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What’s Wrong with Meditation 1 – Expectations

 

By John M. de Castro, Ph.D.

 

“When you meditate, whether you know it or not, you unconsciously setup expectations or conditions. This starts off simple enough. You expect to relax, you expect to release tension from your muscles or core, you expect to find some relief from your day-to-day concerns etc. These expectations, although they may be subconscious and we aren’t aware of them, they are there and often feed the babbler. More so, they greatly limit the depth of meditation you will experience. For the novice, it can make the difference of finding yourself frustrated half way through your meditation because you are dissatisfied that you are not relaxing as much as you had hoped or expected. So by default your session has ended or ironically created more frustration and self-disappointment.” – Eric Pepin

 

How many time have I heard people say, “I tried meditation, but I can’t do it,” or “I tried meditation, but it scared me,” or “I stopped meditating since it didn’t seem to be going anywhere,” or “It’s against my religion to engage in a heathen practice.” These statements are reflective of the large numbers of people who could benefit from meditation but refuse to try it, abandon the practice, or feel that they failed at the practice and abandoned it. All of these statements reflect the prevailing misconceptions and misunderstandings about meditation.

 

I believe that there are three essential problems with the way meditation has been presented in the west that have produced problems, misconceptions, and misunderstandings. First, meditation has been presented in a way that has evoked beliefs, ideas, and images that are overly idealized and not reflective of the typical experiences of meditation practice. Secondly, immediately jumping into meditation practice has been encouraged, without the provision for proper background information, study, or instruction. Lastly, the jargon used to describe the process, experiences, obstacles, and results is extreme, evoking images and expectations that far exceed normal experience.

 

These three problems set up expectations about what the meditator is supposed do and what should be experienced. Unfortunately, that is simply not what actually occurs. As a result, new practitioners quickly give up the practice as they find that they can’t meditate like their image of what meditation should be, they get overwhelmed by the unexpected and powerful psychological issues that arise, sometime precipitating negative consequences, or they are thoroughly disappointed as they discover the promised benefits are subtler than they were led to believe. I’ll admit it, that I was a victim of inaccurate expectations and I’d be willing to bet that at the beginning of a meditation practice most westerners also have them.

 

The media, including print, video, books, and the internet have presented idealized images of meditation, including blissfully meditating people in serene settings. They are presented on the seashore, on mountain tops, at waterfalls, in gorgeous temples, in meditation groups populated by extremely attractive young people, and even floating in the clouds. Just do a google search on meditation pictures and this is what you’ll find. These can be wonderful settings, except perhaps clouds, but are not the usual or even common setting where meditation occurs. Meditation not only doesn’t require this it actually distorts reality. For example, the meditation hall in one of the first meditation centers in the U.S., the San Francisco Zen Center, is located at street level on a noisy, busy city street.

 

Establishing a relatively quiet place to meditate is helpful, but meditation can occur virtually anywhere. I frequently meditate while sitting at the gate at an airport waiting for my flight to board, while in flight, or in a car when I’m a passenger on a long trip. When the weathers nice I like to meditate in my back yard, with the breeze blowing, with noise from traffic barking dogs, and planes passing overhead prevalent. In fact, I find meditation in real-world settings to be particularly beneficial. After all, meditation is useful only to the extent that it transfers to the real world. If meditation only produced effects that only occurred in a quiet room, it wouldn’t be very useful. For meditation effects to transfer to real life, what psychologists call generalization, then the more similar the meditation environment is to the real world, the better. It can be difficult to meditate with all the hubbub and distraction of the real world, but you can learn more, practicing observing without judgment when there’s lots present that you normally judge.

 

The media also presents images of meditating people in perfect lotus posture, with serene, peaceful, and blissful expressions. But, meditation is rarely blissful. It’s wonderful when it is. But, this is the rare exception, not the rule. For that matter it’s rarely peaceful and serene. Once again, it’s great on the rare occasions when it is, but this is not the usual experience. Meditation is often chaotic, sometimes stressful, sometimes troubling, but, if you take an open attitude, it’s always beneficial. That is not to say that meditation does not bring serenity, happiness, and occasional bliss. It does. But, not at first and not with every meditation. These states grow over time. I had people commenting about how I’d changed before I even realized it myself. Be patient. It will happen.

 

Also, very few meditators can comfortably maintain a lotus position. Most find that they are better off sitting in a chair, kneeling with a bench, sitting with a back-jack, or with their feet up in a recliner. We’re taught that getting too comfortable promotes sleepiness and therefore erect sitting postures on a mat are preferred. What is not taught is how excruciating painful these postures can be and how pain is not conducive to meditation. The truth is, each individual needs to experiment to find what works best for them and discard the media’s image of what should be. Meditation is best when the individual is alert but comfortable. Every individual needs to find the position and posture that produces this state of alert comfort best for them.

 

One of the most frequent misunderstandings is that meditation produces a quiet mind. This is generally what is taught and expected with meditation. It’s true with continued practice the mind does settle down and occasionally becomes quiet. But, again, this is not the typical experience, particularly for new meditators. I have frequently asked groups of people who are not practiced meditators to simply try to close their eyes and count breaths while concentrating on their breathing for two minutes. They are often astounded to find that they can’t do this. Within a brief time after beginning their minds wander. I point out to them that they were unable to control their mind even for two minutes. It’s important that the beginning meditator should take note that they can’t control their mind and reflect upon the fact that their notions of control are delusions. They are not in control at all. This is eye opening. It is rarely taught to the beginning meditator, but is perhaps the most important teaching of all before entering into a meditation practice. You can learn from looking at what the mind does rather than trying to quiet it and getting frustrated. You can learn a great deal from the so called “monkey mind.” Fighting it is doomed to failure. Instead watch it and learn. Learn that you are not your mind!

 

It is important that we teach the realities of meditation rather than the ideal. Beginning meditators need to be instructed not to expect to be able to control their minds, but to relax, learn from the internal chaos, don’t fight it and don’t invite it in, just observe it. Don’t worry about perfect posture and position. Explore what works best that produces a state of sustainable alert comfort. Don’t only meditate in quiet comfortable surroundings. Rather, meditate where you are when reflective time is available. It doesn’t have to be for a fixed period of time. Again, experiment and find what works and don’t be afraid to change it. Think of meditation practice as an experiment with one participant. See how it goes, keep what works, and change what doesn’t. Finally, leave expectation at the door. See for yourself. Be open. Let it flow. The benefits will come but only when you stop trying to make them happen.

 

 “‘It is hard to have a balanced view when the media is full of articles attesting to the benefits of meditation and mindfulness. We need to be aware that reports of benefits are often inflated … whereas studies that do not discover significant benefits rarely pick up media interest, and negative effects are seldom talked about.” – Catherine Wikholm

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Decrease Stress Hormones with Meditation

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Decrease Stress Hormones with Meditation

 

By John M. de Castro, Ph.D.

 

“Individuals who scored high on the mindfulness questionnaire also had low levels in cortisol, both before and after the retreat. Subjects whose mindfulness score increased after the retreat also showed a decrease in cortisol.” – Tonya Jacobs

 

Stress is an integral part of life. In fact, I’ve quipped that the definition of death is when stress ceases. People often think of stress as a bad thing. But, it is in fact essential to the health of the body. If the muscles are not stressed to some extent they deteriorate. As it turns out, this is also true for the brain. The same goes for our psychological health. If we don’t have any stress, we call it boredom. In fact, we invest time and resources in stressing ourselves, e.g ridding rollercoasters, sky diving, competing in sports, etc. We say we love a challenge, but, challenges are all stressful. So, we actually love to stress ourselves. In moderation, it is healthful and provides interest and fun to life.

 

If stress, is high or is prolonged, however, it can be problematic. It can damage our physical and mental health and even reduce our longevity, leading to premature deaths. So, it is important that we develop methods to either reduce or control high or prolonged stress or reduce our responses to it. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress. A physiological indicator of stress is the levels of the hormone Cortisol in the blood. Mindfulness training has been shown to reduce Cortisol levels. But, it is not known what types of mindfulness training techniques are effective and which may be less so. Hence, it makes sense to test the effectiveness of different meditation practices to reduce responsiveness to stress as measured by plasma Cortisol levels.

 

In today’s Research News article “Osho Dynamic Meditation’s Effect on Serum Cortisol Level.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198312/

Bansal and colleagues recruited male and female adults, aged 20 to 50 years, who had not previously meditated. They agreed to and participated in 21 consecutive days of Osho meditation practice from 6:00 to 7:00 am daily at a meditation center. “Osho Dynamic Meditation is a 60 minute formatted meditation technique of 5 stages, first of which is fast, deep and chaotic breathing for 10 minutes, followed by 10 minutes of catharsis, 10 minutes of jumping and shouting a mantra “hoo”, 15 minutes of silence, and finally 15 minutes of celebration through dance.” Before and after the 21 days of practice plasma samples were drawn and analyzed for Cortisol levels.

 

They found that after the 21 days of Osho meditation practice every participant showed a decrease in plasma Cortisol levels. On average the decrease was significant and constituted a 29% decline in Cortisol levels. These results suggest that Osho meditation practice may reduce stress levels. This study, however, should be considered as a pilot study. There was no control group, so firm conclusions cannot be drawn. In addition, no other form of mindfulness practice was included to evaluate the relative effectiveness of Osho meditation practice relative to other practices. In addition, no measure of perceived stress was included. So, the present study should be considered a proof of concept study and as evidence that more extensive controlled trials are warranted.

 

So, decrease stress hormones with meditation.

 

“training the mind to focus on immediate experience may reduce the propensity to ruminate about the past or worry about the future, thought processes that have been linked to cortisol release.” – Tonya Jacobs

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Bansal, A., Mittal, A., & Seth, V. (2016). Osho Dynamic Meditation’s Effect on Serum Cortisol Level. Journal of Clinical and Diagnostic Research : JCDR, 10(11), CC05–CC08. http://doi.org/10.7860/JCDR/2016/23492.8827

 

Abstract

Introduction

Dynamic meditation is one of the most popular active meditation, introduced by an Indian mystic Osho in 1970. This one hour meditation consists of five stages: Deep fast chaotic breathing, catharsis, using a mantra “Hoo”, silence, and dancing. A previous study observed that Osho dynamic meditation causes decrease in several psychopathological variables such as aggressive behaviour, anxiety and depression. However, it is not objectively established that the dynamic meditation has an anti-stress effect.

Aim

To find out the effect of Osho dynamic meditation on the serum cortisol levels (cortisol is an indicator of stress) and therefore to observe whether it has any anti-stress effect.

Materials and Methods

An experimental study was planned doing the dynamic meditation empty stomach in morning at 6 to 7 am every day for 21 days from 1st March 2015 to 21st March 2015 at Lucknow. Twenty healthy volunteers between 20 to 50 years (14 males and 6 females) participated in the study. Serum cortisol level was estimated from the blood samples collected in the morning one day prior (baseline) and post-meditation on the 21st day of the study. The difference between mean cortisol levels of the baseline and post-meditation groups were tested for significance by applying the paired t-test.

Results

Sixteen volunteers out of the 20 completed the study while four dropped out due to their health and personal reasons. The serum cortisol levels were decreased in all the 16 participants on 21st day as compared to the baseline levels and the decline in the mean cortisol level was highly significant (p<0.001).

Conclusion

The results of the study showed a significant reduction in plasma cortisol levels when the participants were tested after 21 days of meditation; it can be concluded that the Osho dynamic meditation produces anti-stress effects. The mechanism of action could primarily be attributed to the release of repressed emotions and psychological inhibitions and traumas. Thus, dynamic meditation could be recommended for the amelioration of stress and stress related physical and mental disorders. More clinical studies should be done on dynamic meditation to prove its efficacy and become an approved therapy in hospitals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198312/

 

Change the Brain to Deal with Uncomfortable Sensations with Mindfulness

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Change the Brain to Deal with Uncomfortable Sensations with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Now, as the popularity of mindfulness grows, brain imaging techniques are revealing that this ancient practice can profoundly change the way different regions of the brain communicate with each other – and therefore how we think – permanently.” – Tom Ireland

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. For example, the brain area that controls the right index finger has been found to be larger in blind subjects who use braille than in sighted individuals.  Similarly, cab drivers in London who navigate the twisting streets of the city, have a larger hippocampus, which is involved in spatial navigation, than predefined route bus drivers. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to produce relatively permanent changes in the brain, producing psychological, physical, and spiritual benefits.

 

Dealing with aversive or painful stimuli can be stressful and difficult. There are, however, methods that can improve the individual’s ability to effectively cope with them. Indeed, mindfulness training has been shown to reduce the experience of and response to aversive stimuli and to reduce the physiological and psychological responses to stress. There are indications that mindfulness training may do so by altering the nervous system. The brain regions of the insula and the anterior cingulate cortex have been shown to be involved in interoceptive awareness, that is the conscious appreciation of the internal state of the body. Hence, these structures would be involved in the processing of aversive and painful stimuli. It would seem reasonable, then, to theorize that mindfulness training improves coping with the pain and stress produced by aversive stimuli by changing the activation of the insula and the anterior cingulate cortex.

 

In today’s Research News article “Mindfulness-based training attenuates insula response to an aversive interoceptive challenge.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692309/

Haase and colleagues recruited U.S. Marines who were undergoing pre-deployment training. They were randomly assigned to receive either the usual training or the training plus 8 weeks of mindfulness training occurring in weekly 2-hour sessions. They were also encouraged to practice 30 minutes per day by themselves. Before and after training they were measured for mindfulness, response to stressful experiences, and sleep quality. In addition, both before and after training the Marines completed a vigilance task while their brains underwent Magnetic Resonance Imaging (MRI scans). While they were undergoing scanning, periodically they had their breathing restricted by increasing the load on the lungs to inhale for a number of 1-minute periods. This produced oxygen restriction that was aversive and stressful. The participants rated how aversive the breathing restriction was.

 

They found that the breathing restriction was indeed aversive for both groups and there was no effect of mindfulness training on the aversiveness of the restriction. The mindfulness trained Marines, however, had significantly reduced neural responses from the insula and the anterior cingulate cortex after mindfulness training, while the control group did not. Hence, although mindfulness training did not change the perceived aversiveness of the breathing restriction, it did reduce the response of the brain areas responsible for interoceptive awareness.

 

These results suggest that mindfulness training produced neuroplastic changes in the nervous system, altering the brain areas that are responsible for reacting and consciously appreciating aversive conditions.  It has been previously demonstrated that mindfulness training reduces the experience of, and response to aversive stimuli and stress. Hence, the present findings suggest that neuroplastic alterations to the insula and the anterior cingulate cortex produced by mindfulness training may underlie the improved ability to cope with aversive stimuli.

 

So, change the brain to deal with uncomfortable sensations with mindfulness.

 

“Neuroscientists have also shown that practicing mindfulness affects brain areas related to perception, body awareness, pain tolerance, emotion regulation, introspection, complex thinking, and sense of self. While more research is needed to document these changes over time and to understand underlying mechanisms, the converging evidence is compelling.” – Christina Congleton

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Haase, L., Thom, N. J., Shukla, A., Davenport, P. W., Simmons, A. N., Stanley, E. A., … Johnson, D. C. (2016). Mindfulness-based training attenuates insula response to an aversive interoceptive challenge. Social Cognitive and Affective Neuroscience, 11(1), 182–190. http://doi.org/10.1093/scan/nsu042

 

Abstract

Neuroimaging studies of mindfulness training (MT) modulate anterior cingulate cortex (ACC) and insula among other brain regions, which are important for attentional control, emotional regulation and interoception. Inspiratory breathing load (IBL) is an experimental approach to examine how an individual responds to an aversive stimulus. Military personnel are at increased risk for cognitive, emotional and physiological compromise as a consequence of prolonged exposure to stressful environments and, therefore, may benefit from MT. This study investigated whether MT modulates neural processing of interoceptive distress in infantry marines scheduled to undergo pre-deployment training and deployment to Afghanistan. Marines were divided into two groups: individuals who received training as usual (control) and individuals who received an additional 20-h mindfulness-based mind fitness training (MMFT). All subjects completed an IBL task during functional magnetic resonance imaging at baseline and post-MMFT training. Marines who underwent MMFT relative to controls demonstrated a significant attenuation of right anterior insula and ACC during the experience of loaded breathing. These results support the hypothesis that MT changes brain activation such that individuals process more effectively an aversive interoceptive stimulus. Thus, MT may serve as a training technique to modulate the brain’s response to negative interoceptive stimuli, which may help to improve resilience.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692309/

Reduce Anxiety with Mindfulness and Aroma Therapy

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Reduce Anxiety with Mindfulness and Aroma Therapy

 

By John M. de Castro, Ph.D.

 

“If you have unproductive worries, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

 

Everyone experiences occasional anxiety and that is normal. But, frequent or very high levels of anxiety can be quite debilitating. These are termed anxiety disorders and they are the most common psychological problem. In the U.S., they affect over 40 million adults, 18% of the population, with women accounting for 60% of sufferers One out of every three absences from work are caused by high levels of anxiety and it is the most common reason for chronic school absenteeism. In addition, people with an anxiety disorder are three-to-five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than non-sufferers, making it a major burden on the healthcare system.

 

Anxiety disorders have generally been treated with drugs. It has been estimated that 11% of women in the U.S. are taking anti-anxiety medications. But, there are considerable side effects and these drugs are often abused. Although, psychological therapy can be effective it is costly and only available to a small number of sufferers. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. In addition, aromatherapy, the inhalation of essential oils, has been reported to reduce stress and anxiety, but there has been little systematic scientific study and none combining aromatherapy with mindfulness training.

 

In today’s Research News article “Aromatherapy with two essential oils from Satureja genre and mindfulness meditation to reduce anxiety in humans.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198818/

Soto-Vásquez & Alvarado-García investigated the individual and combined effects of aromatherapy and mindfulness on anxiety in otherwise normal humans. They recruited normal adults between the ages of 25 and 45 years and randomly assigned them to 6 different gender balanced groups; a wait-list control group, mindfulness meditation, aromatherapy with S. brevicalyx essential oil, aromatherapy with S. boliviana essential oil, mindfulness meditation plus aromatherapy with S. brevicalyx essential oil, and mindfulness meditation plus aromatherapy with S. boliviana essential oil. Interventions occurred for 12, 30-minute, sessions over 2 weeks administered Monday through Saturday. Participants were measured for both state and trait anxiety levels before and after treatment.

 

They found that all of the interventions resulted in a significant decrease in both state and trait anxiety levels. The meditation and aromatherapy interventions alone produced and average decrease in state anxiety of 24.1% and trait anxiety of 27.8%. But when meditation and aromatherapy were combined there was, on average, a greater decrease in state anxiety of 34.3% and trait anxiety of 42.4%, although the differences with monotherapy were not statistically significant. All of these effects were of significantly very large magnitude.

 

These are interesting results and suggest that both meditation and aromatherapy effectively reduce anxiety in normal adults. Although not significant the results provide a suggestion that the combination of meditation with aromatherapy produces a greater reduction in anxiety than either alone. This would suggest that they work through different mechanism which can produce additive effects. Unfortunately, the lack of an active control group, greatly reduces confidence in the results. The wait-list control group did not receive any attention, placebo, or active activity. Hence, the results could be due to attentional effects, placebo effects, practice effects, or experimenter bias effects. It remains for future research to investigate these effects with larger groups to improve statistical power and active control conditions to eliminate potential confounds.

 

Regardless, the results are suggestive that aromatherapy and meditation, alone or in combination, may be useful for reducing anxiety in normal humans.

 

“It’s easy to stop noticing the world around us. It’s also easy to lose touch with the way our bodies are feeling and to end up living ‘in our heads’ – caught up in our thoughts without stopping to notice how those thoughts are driving our emotions and behavior. An important part of mindfulness is reconnecting with our bodies and the sensations they experience. This means waking up to the sights, sounds, smells and tastes of the present moment. It’s about allowing ourselves to see the present moment clearly. When we do that, it can positively change the way we see ourselves and our lives.” – Mark Williams

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Soto-Vásquez, M. R., & Alvarado-García, P. A. A. (2017). Aromatherapy with two essential oils from Satureja genre and mindfulness meditation to reduce anxiety in humans. Journal of Traditional and Complementary Medicine, 7(1), 121–125. http://doi.org/10.1016/j.jtcme.2016.06.003

 

Abstract

The goal of this study was to verify whether association of aromatherapy with essential oils of Satureja brevicalyx or Satureja boliviana and mindfulness meditation can reduce anxiety levels in humans. A randomized experimental trial was carried out with 108 participants who were divided into 6 groups, comprising a waiting list control group and five experimental groups. Aromatherapy was carried out by inhalation of essential oils while mindfulness intervention program was focused on “flow meditation”. The anxiety index was evaluated by State-Trait Anxiety Inventory (STAI). Measures were taken two times: pretest and posttest. State and Trait anxiety scores showed a decrease in posttest study phase in comparison with pretest in all experimental groups (p < 0.005), especially in those where aromatherapy and mindfulness meditation were used together. All Cohen’s d scores were over to 1 that means a large size effect in anxiety variable. Percentages of change showed reductions of anxiety variable ranging between 20% and 47%. All treatments used isolated or associated, may be considered alternative treatment options for anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198818/

Reduce Youth Dissociative Disorders with Mindfulness

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Reduce Youth Dissociative Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It sounds elementary, I know. But that’s the beauty of it. Rather than wasting energy fighting dissociation, we can decrease its severity simply by increasing awareness.” – Holly Gray

 

Sometime during the lives of about 2% of the population, a Dissociative Disorder occurs. It is more likely in women than in men and is most frequently triggered by a traumatic event. Dissociative Disorders involve an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. These can include significant memory loss of specific times, people and events, out-of-body experiences, such as feeling as though you are watching a movie of yourself, mental health problems such as depression, anxiety and thoughts of suicide, a sense of detachment from emotions, or emotional numbness, and a lack of a sense of self-identity.

 

There are three kinds of diagnosed Dissociative Disorders, Dissociative Amnesia, Depersonalization disorder, and Dissociative identity disorder (aka multiple personalities). These disorders are thought to be coping mechanisms for intense stress. They are generally treated with drugs, particularly antidepressants, and with psychotherapies including Cognitive Behavioral Therapy and Dialectical Behavioral Therapy. Mindfulness training has been found to be effective in treating a myriad of mental and physical disorders and particularly with stress related disorders. It has also been shown to be effective with trauma reactions including Post-Traumatic Stress Disorder (PTSD). So, it makes sense to test the effectiveness of mindfulness training in treating Dissociative Disorders.

 

In today’s Research News article “Role of mindfulness in Dissociative Disorders among adolescents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100126/

Sharma and colleagues recruited a small sample of adolescents (average age = 13 and 86% female) who were diagnosed with a Dissociative Disorder. They were provided 6 weekly sessions of mindfulness training based upon the Mindfulness-Based Stress reduction (MBSR) program and encouragement to practice at home. The treatment included both sitting and walking meditation, body scan, yoga, and mindful eating practices. They were measured for dissociative experiences and mindfulness, before treatment, 3 weeks into treatment, and immediately after treatment.

 

They found that the treatment produced a significant, 54% decrease in dissociative symptoms and a 25% increase in mindfulness. The increase in mindfulness would be expected, given the extensive literature demonstrating increases in mindfulness produced by MBSR training. The decrease in dissociative symptoms is, to our knowledge, unprecedented. It is reasonable though given the demonstrated ability of mindfulness training to improve present moment awareness and decrease mind wandering. Attending to what is happening in the present moment would tend to counteract tendencies to drift away from reality.

 

These are potentially important results but should be looked upon as a pilot, proof of concept study. There was no control condition and the sample was small and confined to young adolescents, primarily girls. The results, though, provide a strong rationale to implement a large scale randomized controlled clinical trial. This could provide evidence that mindfulness training may be an effective treatment for dissociative disorders.

 

“Having a daily mindfulness practice allows you to reach trauma, implicit memories and a way of integrating your childhood abuse. You start with neutral judgements and work towards emotional charged memories. You can heal much quicker than you believe. It takes daily work strengthening your focus on the breath. It seems mundane to focus on the breath but the breath controls the nervous system and allows us to reach our trauma quickly and decisively.” – Marty

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and Twitter @MindfulResearch

 

Study Summary

Sharma, T., Sinha, V. K., & Sayeed, N. (2016). Role of mindfulness in dissociative disorders among adolescents. Indian Journal of Psychiatry, 58(3), 326–328. http://doi.org/10.4103/0019-5545.192013

 

Abstract

Context: Dissociation is understood as maladaptive coping and is common in children and adolescents. Treatment outcome studies show improvement in comorbid conditions suggesting the need to implement programs that target dissociative pathology.

Aim: To study the effect of practicing mindfulness among adolescents diagnosed with dissociative disorders.

Settings and Design: It was a hospital-based repeated measures design.

Materials and Methods: 7 adolescents participated in a mindfulness-based therapeutic program for 6 weeks.

Statistical Analysis: Scores were expressed as mean ± standard deviation. Friedman test was used to assess significance of the difference in scores at various assessment phases. Wilcoxon signed rank test was used for post hoc analysis.

Results: Participants were mostly female adolescents from rural, Eastern India. There was a significant reduction in dissociative experiences and significant improvement in mindfulness.

Conclusions: Incorporating mindfulness in clinical practice may prove effective in reducing dissociation and promoting adaptive functioning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100126/